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Readability of Patient Education Materials Available at the Point of Care

  • Original Research
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Abstract

Background

Many patient education materials (PEMs) available on the internet are written at high school or college reading levels, rendering them inaccessible to the average US resident, who reads at or below an 8th grade level. Currently, electronic health record (EHR) providers partner with companies that produce PEMs, allowing clinicians to access PEMs at the point of care.

Objective

To assess the readability of PEMs provided by a popular EHR vendor as well as the National Library of Medicine (NLM).

Design

We included PEMs from Micromedex, EBSCO, and MedlinePlus. Micromedex and EBSCO supply PEMs to Meditech, a popular EHR supplier in the US. MedlinePlus supplies the NLM. These PEM databases have high market penetration and accessibility.

Measurements

Grade reading level of the PEMs was calculated using three validated indices: Simple Measure of Gobbledygook (SMOG), Gunning Fog (GFI), and Flesch–Kincaid (FKI). The percentage of documents above target readability and average readability scores from each database were calculated.

Results

We randomly sampled 100 disease-matched PEMs from three databases (n = 300 PEMs). Depending on the readability index used, 30-100% of PEMs were written above the 8th grade level. The average reading level for MedlinePlus, EBSCO, and Micromedex PEMs was 10.2 (1.9), 9.7 (1.3), and 8.6 (0.9), respectively (p ≤ 0.000) as estimated by the GFI. Estimates of readability using SMOG and FKI were similar.

Conclusions

The majority of PEMS available through the NLM and a popular EHR were written at reading levels considerably higher than that of the average US adult.

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Acknowledgements

The Doris Duke Charitable Foundation for The Doris Duke Clinical Research Fellowship.

Seth Zimmerman, BA, computer program design.

Alex Federman, MD, manuscript revisions.

Lauren Stossel had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.

Conflict of Interest

The authors declare that they do not have a conflict of interest.

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Authors and Affiliations

  1. Mount Sinai School of Medicine, One Gustave L. Levy Place, Box 1257, New York, NY, 10029-6574, USA

    Lauren M. Stossel BA

  2. Department of Internal Medicine, Yale School of Medicine, 15 York Street, Box 208030, New Haven, CT, 06520-8030, USA

    Nora Segar MD, MPH

  3. Department of Medical Education, Mount Sinai School of Medicine, One Gustave L. Levy Place, Box 1257, New York, NY, 10029-6574, USA

    Peter Gliatto MD & Reena Karani MD

  4. The Mount Sinai Hospital, One Gustave L. Levy Place, New York, NY, 10029, USA

    Robert Fallar MS

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  1. Lauren M. Stossel BA
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  2. Nora Segar MD, MPH
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Correspondence to Lauren M. Stossel BA.

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Stossel, L.M., Segar, N., Gliatto, P. et al. Readability of Patient Education Materials Available at the Point of Care. J GEN INTERN MED 27, 1165–1170 (2012). https://doi.org/10.1007/s11606-012-2046-0

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  • DOI: https://doi.org/10.1007/s11606-012-2046-0

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